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c/survodutide·posted 4 months ago by u/paper_trail_paula

biopsy is the most under-discussed thing on this board

Question Long Haul ×8 Sourced ×3

biopsy is the most under-discussed thing on this board. I have gone back and forth on this for months.

Phase 2 in a biopsy-confirmed population is a demanding design: recruitment is slow, the population is specific, and the results do not generalise to people who have not been characterised that way.

It is a dual agonist at the GLP-1 and glucagon receptors. The glucagon arm is associated with increased energy expenditure and with effects on hepatic fat, which is why the development programme is oriented towards liver disease.

Histological endpoints in this field are scored on biopsy: resolution of steatohepatitis without worsening of fibrosis, or improvement in fibrosis without worsening of steatohepatitis. Both are harder to achieve and to interpret than an imaging surrogate.

Tell me where this is wrong. That is the useful part of posting it.

1,016 up / 48 down95% upvoted13 commentsid 1wnvgj31 Mar 2026

13 comments

6 in this archive, depth 2

best — the order this archive was captured in

u/elin_tamm-37 points·4 months ago

Independent purity results for this compound are very sparse across the whole site, which means any impression about consistency is built on almost nothing.

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u/incretin_ivypharmacology95 points·4 months ago

Nothing containing this compound is approved anywhere. Research-use-only material is not approved for human use.

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u/honest_syringe_pls51 points·3 months ago

Disagree — that is a weight endpoint from a different programme and you are quoting it in a hepatic context.

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u/endotoxin_elliemicro77 points·4 months ago·edited

Push back: the evidence here is phase 2, in a specific population, and it does not support a general ranking.

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u/nora_oyelaran17 points·4 months ago

The escalation schedules in the published protocols are slow and deliberate, and the tolerability tables show why. That is a description of the trials rather than a suggestion for anybody.

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u/injection_site_iris60 points·4 months ago

Imaging-derived liver fat fraction is a surrogate. It correlates with histology imperfectly, and a trial reporting one is not reporting the other.

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Survodutide-specific discussion: glucagon-receptor co-agonism, the hepatic fat and MASH resolution data, and how the side-effect profile compares with GIP-based dual agonism. Small community, high signal.

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